Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.60 / $42.46 / $111.26	Facility		$36.60	$42.46	$111.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.03 / $28.40 / $42.46	Professional		$19.03	$28.40	$42.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.58 / $77.06 / $105.10	Facility		$47.58	$77.06	$105.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.96 / $33.86 / $52.28	Professional		$20.96	$33.86	$52.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $71.77 / $77.45	Professional		$29.28	$71.77	$77.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $26.54 / $36.81 / $97.94	Facility		$26.54	$36.81	$97.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $33.67 / $58.90	Professional		$29.28	$33.67	$58.90
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $29.28 / $35.14 / $75.84	Facility		$29.28	$35.14	$75.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.54 / $36.81 / $84.91	Facility		$26.54	$36.81	$84.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.28 / $36.60 / $47.93	Professional		$29.28	$36.60	$47.93
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $57.10 / $90.35 / $120.97	Facility		$57.10	$90.35	$120.97
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $37.31 / $72.20	Professional		$26.36	$37.31	$72.20
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.73 / $35.14	Professional		$12.30	$16.73	$35.14